本文關鍵詞：類風濕關節(jié)炎患者的骨密度與25-羥維生素D3的相關性研究　出處：《川北醫(yī)學院》2016年碩士論文　論文類型：學位論文

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【摘要】：目的:本研究通過對RA患者的外周血的25(OH)D3水平及左手前臂中下1/3處骨密度(BMD)的測量,根據(jù)不同組間RA患者血漿25(OH)D3濃度變化和骨密度差異,探討類風濕關節(jié)炎的發(fā)病機制及二者與類風濕關節(jié)炎嚴重程度的相關性,為RA疾病的診斷治療提供依據(jù)。方法:收集川北醫(yī)學院附屬風濕免疫科2014年7月至2015年8月門診及住院部的82例類風濕關節(jié)炎患者及52例健康者外周血,根據(jù)RA患者手指骨X平片表現(xiàn)分期不同,將患者分為4組,其中I組22例、Ⅱ組29例、Ⅲ組19例、Ⅳ組12例。將收集的外周血標本通過ELISA方法檢測血清25(OH)D3水平,同時應用EXA-3000雙能X射線骨密度測量儀測量類風濕關節(jié)炎患者和健康者的左側前臂中下1/3處的骨密度,對比分析不同嚴重程度分組RA患者血清25(OH)D3水平和骨密度的變化及意義,探討RA患者血清25(OH)D3水平和骨密度與RA的關系。結果:1.RA組的25(OH)D3濃度為(23.51±3.02)ng/ml明顯低于對照組的25(OH)D3濃度(26.25±3.74)ng/ml,差異具有統(tǒng)計學意義(P0.05);而RA組的骨密度為(0.329±0.072)g/cm2,明顯低于對照組的骨密度(0.465±0.065)g/cm2,差異具有統(tǒng)計學意義(P0.05)。2.RA患者I組、Ⅱ組、Ⅲ組、Ⅳ組4組及健康對照組的25(OH)D3濃度分別為(26.06±4.05)ng/ml、(20.45±3.38)ng/ml、(17.37±2.88)ng/ml、(14.01±2.45)ng/ml、(26.25±3.74)ng/ml。I組25(OH)D3濃度與健康對照組比較,差異無統(tǒng)計學意義(p0.05);組25(OH)D3濃度明顯低于健康對照組,差異有統(tǒng)計學意義(p0.05);ra患者i、Ⅱ、Ⅲ、Ⅳ各組之間兩兩比較,iv組25(oh)d3濃度明顯低于Ⅲ組,差異有統(tǒng)計學意義(p0.05);Ⅲ組25(oh)d3濃度明顯低于i、Ⅱ組,差異有統(tǒng)計學意義(p0.05);Ⅱ組25(oh)d3濃度明顯低于i組,差異有統(tǒng)計學意義(p0.05)3.ra患者i組、Ⅱ組、Ⅲ組、iv組4組及健康對照組的骨密度(bmd)分別為(0.457±0.061)g/cm2、(0.318±0.035)g/cm2、(0.297±0.049)g/cm2、(0.235±0.024)g/cm2、(0.465±0.065)g/cm2。i組骨密度與健康對照組比較,差異無統(tǒng)計學意義(p0.05);Ⅱ組、Ⅲ組、Ⅳ組骨密度明顯低于健康對照組,差異有統(tǒng)計學意義(p0.05);ra患者i、Ⅱ、Ⅲ、iv各組之間兩兩比較,iv組骨密度明顯低于Ⅲ組,差異有統(tǒng)計學意義(p0.05);Ⅲ組骨密度明顯低于i、Ⅱ組,差異有統(tǒng)計學意義(p0.05);Ⅱ組骨密度明顯低于i組,差異有統(tǒng)計學意義(p0.05)。4.ra各組患者外周血25(oh)d3濃度隨著疾病的嚴重程度增加而降低,呈負相關,相關系數(shù)r=-0.72,相關性有統(tǒng)計學意義(p0.05);ra各組患者骨密度隨著疾病的嚴重程度增加而降低,呈負相關,相關系數(shù)r=-0.63,相關性有統(tǒng)計學意義(p0.05);ra各組患者外周血25(oh)d3濃度與骨密度呈正相關,相關系數(shù)r=0.67,相關性有統(tǒng)計學意義(p0.05)。結論:1.ra患者外周血25(oh)d3濃度與骨密度較對照組明顯降低,推測25(oh)d3可能參與了ra的發(fā)生發(fā)展。2.隨著ra病情加重,患者血清25(oh)d3濃度與骨密度逐漸降低,且25(oh)d3濃度與骨密度呈正相關,25(oh)d3濃度與骨密度可能成為RA病情嚴重程度的評估指標。3.推測RA患者服用維生素D可抑制自身免疫反應,緩解RA急性期癥狀,延緩疾病進展。
[Abstract]:Objective: To study the peripheral blood of patients with RA 25 (OH) D3 levels and the left forearm and lower 1/3 of bone mineral density (BMD) measurements, according to the different groups of patients with RA 25 (OH) D3 concentration and bone density differences, to explore the pathogenesis of rheumatoid arthritis and two with rheumatoid arthritis severity, provide the basis for the diagnosis and treatment of RA disease. Methods: 82 cases of patients with rheumatoid arthritis were collected affiliated to North Sichuan Medical College Department of Rheumatology in July 2014 to August 2015 in outpatient and inpatient and 52 cases of normal peripheral blood of RA patients, according to the finger bone X flat performance in different stages, the patients were divided into 4 group, including 22 cases of I group, 29 cases of group II, 19 cases of group III, IV group of 12 cases. The collected peripheral blood samples by ELISA method for the detection of the serum level of D3 25 (OH), at the same time the application of EXA-3000 dual energy X ray absorptiometry measurement of rheumatoid arthritis patients and health 搴瘋，

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